Identifying and quantifying exposures involving counterfeit opioid analgesic products.

IF 3 3区 医学 Q2 TOXICOLOGY
Nancy A West, Gabrielle E Bau, Heather Olsen, Hannah L Burkett, Geoffrey Severtson, Brooke Kritikos, Amanda Rogers, Richard C Dart, Joshua C Black
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引用次数: 0

Abstract

Introduction: The increasing presence of counterfeit opioid drugs in the United States can contaminate data collection systems and confound estimates derived from surveillance of the opioid epidemic. Data sources and analyses that can quantify the contribution of counterfeit opioid products are needed to provide accurate and timely data to inform public health responses. We describe a novel approach to identify and quantify intentional abuse and misuse exposures involving suspected counterfeit opioid products in United States poison center data.

Methods: An ecological study was performed using data, including narrative case notes, reported to participating United States Poison Centers of the Researched Abuse, Diversion and Addiction Related Surveillance System between 2009-Quarter 1 and 2021-Quarter 4. A machine learning natural language processing approach was used to develop a predictive model.

Results: Sensitivity for detecting suspected non-counterfeit-involved exposures by the predictive model was 92%, specificity was 73%, and the area under the receiver operating characteristic curve was 92%. Overall, only 2.1% of intentional abuse and misuse exposure calls were predicted to be suspected counterfeit-involved during 2009-2021; however, we observed an exponential increase in suspected counterfeit exposures over this time period. There was a 7-fold increase in the estimated number of suspected counterfeit exposures from 2009 to 2021, and 23.7% of all opioid analgesic intentional abuse and misuse exposures were suspected counterfeit-involved in 2021.

Discussion: We demonstrate the feasibility and reliability of using machine learning natural language processing to identify exposures involving suspected counterfeit opioid products in United States poison center data. Results suggest that suspected counterfeits have had a meaningful influence on rates of intentional abuse exposures to opioid analgesics in more recent years.

Conclusions: The increasing presence of counterfeit opioid drugs can contaminate data collection systems and compromise the reliability of the data.

识别和量化涉及假冒阿片类镇痛药产品的暴露。
导言:美国阿片类假药的日益增多会污染数据收集系统,混淆阿片类流行病监测得出的估计值。为了提供准确及时的数据,为公共卫生应对措施提供信息,我们需要能够量化假冒阿片类产品的数据来源和分析方法。我们介绍了一种在美国毒物中心数据中识别和量化涉及疑似假冒阿片类产品的故意滥用和误用暴露的新方法:我们利用 2009 年第 1 季度至 2021 年第 4 季度期间向美国毒物中心参与研究的滥用、转用和成瘾相关监测系统报告的数据(包括病例记录)开展了一项生态学研究。采用机器学习自然语言处理方法开发了一个预测模型:结果:预测模型检测到疑似非假冒产品暴露的灵敏度为 92%,特异度为 73%,接收器工作特征曲线下的面积为 92%。总体而言,在 2009-2021 年期间,仅有 2.1% 的故意滥用和误用曝光电话被预测为疑似涉及假冒产品;但是,我们观察到在此期间疑似假冒产品曝光呈指数增长。从 2009 年到 2021 年,疑似假药暴露的估计数量增加了 7 倍,到 2021 年,在所有阿片类镇痛药有意滥用和误用暴露中,有 23.7% 疑似涉及假药:我们展示了利用机器学习自然语言处理技术识别美国毒物中心数据中涉及疑似假冒阿片类产品的暴露的可行性和可靠性。结果表明,近年来,疑似假冒产品对阿片类镇痛药的故意滥用暴露率产生了有意义的影响:结论:阿片类药物假药的日益增多会污染数据收集系统,损害数据的可靠性。
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来源期刊
Clinical Toxicology
Clinical Toxicology 医学-毒理学
CiteScore
5.70
自引率
12.10%
发文量
148
审稿时长
4-8 weeks
期刊介绍: clinical Toxicology publishes peer-reviewed scientific research and clinical advances in clinical toxicology. The journal reflects the professional concerns and best scientific judgment of its sponsors, the American Academy of Clinical Toxicology, the European Association of Poisons Centres and Clinical Toxicologists, the American Association of Poison Control Centers and the Asia Pacific Association of Medical Toxicology and, as such, is the leading international journal in the specialty.
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